CLINICAL AND NEUROPHYSIOLOGICAL PARALLELS OF THE BRACHIAL PLEXOPATHY IN THE STRUCTURE OF NEUROGENIC THORACIC OUTLET SYNDROME

Abstract

The aim: Was assessment of the neurophysiological data and features of clinical picture in patients with neurogenic thoracic outlet syndrome (TOS). Materials and methods: 103 patients with upper extremity pain and/or paresthesia or hypotrophy, or a combination of these symptoms were examined. The examination algorithm included: cervical spine radiography, cervical spine and brachial plexuses magnetic resonance imaging (MRI), upper extremity soft tissues and vessels ultrasonic examination, stimulation electroneuromiography with F-waves registration. Results: Neurogenic TOS was diagnosed in 29 patients. A significant relationship between the following complaints and neurophysiological parameters was observed: pain, numbness during physical activity and decreased medial anrebrachial cutaneous nerve response amplitude by ≥25% compared to the contralateral side; hypothenar hypotrophy and decrease of ulnar nerve motor/sensory response amplitude; the 4-5th fingers hypoesthesia and decrease of ulnar nerve sensory response amplitude. Conclusions: Medial antebrachial cutaneous nerve amplitudes asymmetry indices of ≥25% or lack of response may be considered to be a marker of true neurogenic TOS.